Is exercise therapy effective in improving symptoms of post-traumatic stress disorder in adults?

OBJECTIVE: The objective of this systematic review is to determine whether or not exercise therapy is effective in improving symptoms of post-traumatic stress disorder (PTSD) in adults. STUDY DESIGN: Review of two randomized controlled trials (RCTs) published in 2015 and 2018 and one case-series study published in 2015; all articles were published in English language and compared the efficacy of exercise therapy for improvement of PTSD symptoms in adults. DATA SOURCES: Two RCTs and one case-series study were found using PubMed. All of the articles were published in peer reviewed journals. All articles were selected based on their relevance to the clinical question and whether the outcomes of the research were patient oriented evidence that matters (POEMs). OUTCOMES MEASURED: Reduction in PTSD symptom severity after completing an exercise program was measured through CAPS interview and PCL-C scores. RESULTS: The RCT conducted by Rosenbaum et al. had a statistically significant mean change from baseline in PCL-C scores of 9.8 between the group receiving exercise therapy compared to the control group’s mean change from baseline of 4.2; p=0.04 (p \u3c0.05). In the RCT by Goldstein et al., the mean change from baseline in CAPS scores for the integrative exercise (IE) group was 30.64 after the 12-week program, compared to a mean change from baseline in CAPS scores of 14.27 for the waitlist control group. The study reported a Cohen’s d of -0.90, indicating a large treatment effect for the IE group. The case-series study by Fetzner et al. reported a Cohen’s d score of 0.98, indicating the effect of exercise in reducing PTSD symptoms was large based on reported PCL-C scores for the 11 participants enrolled. CONCLUSION: This systematic review concludes that exercise therapy is an effective, inexpensive and well-accepted treatment for reducing symptoms of PTSD in adults. Two RCTs and one case-series study have provided statistically and clinically significant evidence supporting that exercise reduces symptoms such as avoidance, re-experiencing, numbness, and hyperarousal that many adults suffering with PTSD experience